Gonorrhoea is a sexually transmitted infection, which is transmitted very easily and can lead to severe and permanent health consequences if untreated.
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One of the most common sexually transmitted infections (STIs) in Singapore is gonorrhoea. This is a bacterial infection that’s transmitted very easily; just one act of sexual intercourse with a man who has gonorrhoea will transmit the infection up to 80% of the time. However, the disease requires sex to be transmitted; it cannot be passed on objects such as toilet seats.
Symptoms
It takes about one to two weeks after being exposed to the bacteria for the symptoms of gonorrhoea to develop. In some cases, symptoms never become apparent; about half of women who have gonorrhoea don’t have symptoms, although it’s less common for men to be asymptomatic. It’s possible for gonorrhoea to progress into the more advanced stages even if there are initially no symptoms.
When symptoms do occur, they include vaginal or penile discharge, burning during urination or ejaculation, pain with sexual intercourse, swelling and redness of the external genitals, pelvic pain, and menstrual irregularities (such as bleeding between periods).
Gonorrhoea can also occur in the throat, where it causes a sore or itchy throat; this is acquired by performing oral sex on an infected partner. Anal gonorrhoea also occurs; anal discharge along with itching or burning of the anus are the symptoms. For both oral and anal gonorrhoea, being asymptomatic is very common.
Gonorrhoea that isn’t treated may progress into the deeper reproductive organs, such as the fallopian tubes and the testicles. The damage caused by this type of infection can cause infertility, which is often permanent even after the infection is treated. The infection can even spread further into the rest of the body, causing damage to the joints, heart, brain, and spinal cord. Again, this damage is often permanent even after the infection is treated.
In pregnant women, gonorrhoea can be passed to the newborn during birth. This can cause eye infections, leading to blindness, as well as to other health problems. All pregnant women with gonorrhoea should be adequately treated prior to birth to avoid this outcome.
Diagnosis
While the symptoms of gonorrhoea may be suggestive of the diagnosis, they’re similar to the symptoms of other sexually transmitted diseases, and so testing is needed to confirm the diagnosis. A swab of the discharge is sent to the laboratory to check for microorganisms.
When screening for gonorrhoea, a urine test is often used. While this test is not as sensitive (meaning that it sometimes misses cases of gonorrhoea), it’s much easier to perform. In Singapore, gonorrhoea screening is performed on all pregnant women, and is done once a year on most sexually active adults who have new or frequent partners.
Treatment
Oral or injected antibiotics are used to treat gonorrhoea. More than one medication at a time is often used. The patient’s partner(s) must also receive treatment, even if there are no symptoms. This avoids reinfecting the patient and prevents long-term health consequences in the partner(s).
Prevention
To be certain of preventing gonorrhoea, it would be necessary to abstain completely from all types of sex, or to restrict sex to within a long-term mutually monogamous relationship. However, condoms are also effective at preventing gonorrhoea, and will work most of the time. You need to use a condom when having any type of sex, whether vaginal, oral, or anal, and use a dental dam or piece of plastic wrap when performing oral sex on a woman.
References
Gonorrhoea at Shim Clinic, Singapore